Korey M Davis, ATP
Individual provider Active NPI Other Technician · Abilene, TX
NPI 1346772860 · NPPES record last updated Apr 5, 2017
Key facts
- NPI
- 1346772860
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Other Technician 247200000X
- License
- 86326 (TX)
- Practice address
- 3374 S Treadaway Blvd
Abilene, TX 79602-6736 - Phone
- (325) 437-3350
- Fax
- (325) 437-3420
- NPI assigned
- Apr 3, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86326 | TX | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | 86326 | TX | Yes |
Addresses
Primary practice location
3374 S Treadaway Blvd
Abilene, TX 79602-6736
Mailing address
3374 S Treadaway Blvd
Abilene, TX 79602-6736
Phone (325) 437-3350
Other providers in Abilene, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.